Nelfinavir mesylate is one of several protease inhibitors used to limit viral replication and improve immune function in HIV-infected individuals. Information regarding nelfinavir mesylate is reported in “Viracept (Nelfinavir Mesylate, AG1343): A Potent, Orally Bioavailable Inhibitor of HIV-1 Protease”, Kaldor et al., J. Med. Chem., 40, 3979–85 (1997), and its use in the treatment of HIV is reported in “Nelfinavir: An Update on its Use in HIV Infection”, Bardsley-Elliot et al., Drugs, 59(3), 581–620 (2000).
Nelfinavir mesylate is a white to off-white amorphous powder that is slightly soluble in water at pH less than or equal to 4. Nelfinavir mesylate has a molecular weight of 663.90 (567.79 as the free base).
Nelfinavir mesylate is commercially available as a 250 mg tablet (as nelfinavir free base). It is sold under the name Viracept® by Agouron Pharmaceuticals, Inc., a Pfizer company. Viracept® tablets are known to additionally contain calcium silicate, crospovidone, magnesium stearate, FD&C blue #2 powder, hydroxypropyl methylcellulose and triacetin. U.S. Pat. No. 6,001,851 to Albizati et al., assigned to Agouron Pharmaceuticals, Inc., reports a tablet composition (formulation 9) containing 292 mg of an HIV inhibitor which can be nelfinavir mesylate. The patent does not specify the market formulation, Viracept®, although the reported composition contains calcium silicate, crospovidone and magnesium stearate. Calcium silicate and crospovidone each constitute about 25% of the composition reported in the patent.
For adult patients, the recommended oral dosage of nelfinavir mesylate (calculated as nelfinavir free base) is 750 mg (3×250 mg tablets) 3 times daily or an alternative regimen of 1250 mg (5×250 mg tablets) twice daily. Whether a two- or three-times per day dosage program is followed, the tablet burden remains significant over the course of a day. Patient compliance is therefore a real concern.
Block copolymers of ethylene oxide and propylene oxide that are listed as poloxamers in the NF Monograph “Poloxamer” are available in a wide range of molecular weights and melting points. They are marketed under the name Lutrol® or Pluronic® by BASF Corporation. Poloxamers have been extensively used as pharmaceutical wetting and solubilizing agents, typically in small amounts.
It has also been noted that poloxamers can be used in pharmaceutical formulations to enhance the bioavailability of a drug. U.S. Pat. No. 5,834,472 to Sangekar et al., for example, reports that including a non-ionic surfactant that is a block copolymer of ethylene oxide and propylene oxide in a composition of an antifungal compound having extremely low water solubility can enhance the bioavailability of the compound. U.S. Pat. No. 5,281,420 to Kelm et al. addresses formulation of the drug tebufelone, an anti-inflammatory, analgesic and/or antipyretic agent that is essentially water-insoluble. Absorption of tebufelone is quite low from the gastrointestinal tract. Kelm et al. report a solid dispersion of tebufelone, produced by melting together poloxamer and tebufelone (melting point of about 70° C.) to form a homogeneous melt mixture. Solid dispersions of the homogeneous melt mixture result from cooling the mixture and allowing it to solidify. The poloxamer surfactant is included to provide the necessary solubilization of the highly insoluble drug in forming the melt mixture.
A high dosage strength solid unit oral dosage form, e.g., a tablet, of nelfinavir mesylate having satisfactory dissolution and bioavailability has apparently not been successfully developed prior to the present invention. This may be due in part to the hydrophobic nature of the drug, which accounts for its low aqueous solubility. In addition, nelfinavir mesylate in high dose solid unit dosage forms gels upon exposure to physiological fluid. The gel retards dissolution and bioavailability of the drug. The problem of gelling worsens with increased drug loading.